Health-Related Quality of Life in Locally Advanced Gastric Cancer: A Systematic Review.

Abstract

Simple SummaryEvaluating health-related quality of life (HRQOL) is important because it reflects the impact of treatment from the patient’s perspective. This holds especially true when prognosis is poor, as is the case for gastric cancer patients. This systematic review was performed to evaluate the short- and long-term impacts of current treatments on HRQOL in patients with locally advanced gastric cancer. The results of this review show that surgery and chemoradiotherapy have a significant impact on short-term HRQOL, although this recovers after 6–12 months. More focus on HRQOL in current clinical practice might improve patient counselling and monitoring before, during, and after treatment in locally advanced gastric cancer patients.Background: Current treatment strategies have been designed to improve survival in locally advanced gastric cancer patients. Besides its impact on survival, treatment also affects health-related quality of life (HRQOL), but an overview of reported studies is currently lacking. The aim of this systematic review was therefore to determine the short- and long-term impact of chemotherapy, surgery, and (chemo)radiotherapy on HRQOL in locally advanced, non-metastatic gastric cancer patients. Methods: A systematic review was performed including studies published between January 2000 and February 2021. We extracted studies published in Medline, Embase, and Scopus databases that assessed HRQOL in patients with locally advanced, non-metastatic gastric cancer treated with curative intent. Studies using non-validated HRQOL questionnaires were excluded. Short-term and long-term HRQOL were defined as HRQOL scores within and beyond 6 months after treatment, respectively. Results: Initially, we identified 8705 articles (4037 of which were duplicates, i.e., 46%) and ultimately included 10 articles. Most studies reported that short-term HRQOL worsened in the follow-up period from 6 weeks to 3 months after surgery. However, recovery of HRQOL to preoperative levels occurred after 6 months. After completion of chemoradiotherapy, the same pattern was seen with worse HRQOL after treatment and a recovery of HRQOL after 6–12 months. Conclusions: In patients with locally advanced, non-metastatic gastric cancer, HRQOL deteriorated during the first 3 months after surgery and chemoradiotherapy. However, the long-term data showed a recovery of HRQOL after 6–12 months. To implement HRQOL in clinical decision making in current clinical practice, more research is needed.